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Small advanced colorectal adenocarcinomas: report on three cases
Endoscopy
|August 7, 1998
Summary
Small advanced colorectal cancers, though rare and difficult to diagnose endoscopically, possess a high malignant potential. Early detection using magnifying endoscopy is crucial for these aggressive tumors.
Area of Science:
- Gastroenterology
- Oncology
- Endoscopic Imaging
Background:
- Small advanced cancers (<10 mm) are infrequently reported due to diagnostic challenges.
- Colonoscopic screening is essential for early cancer detection.
Observation:
- Three cases of small advanced colorectal cancer (0.05%) were identified during 5120 colonoscopies.
- Lesions were flat, depressed (8-9 mm), and exhibited a V-type pit pattern under magnifying endoscopy with indigo carmine dye spray.
Findings:
- Histological analysis confirmed invasion into the proper muscle layer in all three cases.
- Two cases showed lymph node metastasis, indicating advanced disease.
- K-ras mutation was absent; p53 staining was positive in two cases (diffuse and focal).
Implications:
- Small advanced colorectal adenocarcinomas are a significant clinical entity.
- These tumors demonstrate a high malignant potential, underscoring the need for improved diagnostic strategies.
- Magnifying endoscopy with dye spraying is effective in diagnosing these challenging lesions.